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INTRODUCTION
CREMAGEL 2% GEL contains Diltiazem which belongs to the group of medicines called Calcium Channel Blockers. It is used to treat anal fissures (a cut or tear in the back passage). It reduces pain and promotes the healing of the tear that has occurred in the skin of the anus.
Apply CREMAGEL 2% GEL regularly as instructed by your doctor. It is for external use only. Wash your hands before and after application. Use a finger covering, such as cling film or a disposable glove to apply the medicine. Discard the finger covering after use. Avoid contact of CREMAGEL 2% GEL with your eyes, ears, nose, mouth or vagina.
Before using CREMAGEL 2% GEL inform your doctor if you have any heart problems. You must also inform your doctor if you have low blood pressure, anemia, increased pressure in the brain or severe dehydration as a precaution.
If you are a pregnant or breast-feeding women, consult your doctor for advice before using CREMAGEL 2% GEL. The most common side effects of applying CREMAGEL 2% GEL are headache, feeling dizzy while changing position and local itching or burning sensation. Contact your doctor if any of these side effect worsens.
USES OF CREMAGEL 2% GEL
- Treats anal fissures (cut or tear in the anus)
HOW CREMAGEL 2% GEL WORKS
CREMAGEL 2% GEL effectively heals anal fissures, where diltiazem acts by relaxing the muscle around the anus (back passage). This action reduces pressure around the anal regions and increases blood flow which promotes healing of cuts and tears in the anus.
DIRECTIONS FOR USE
Take a small amount of CREMAGEL 2% GEL on your finger (approximately 2.5 cm) and gently apply the medicine inside and around the anus or as directed by your physician. CREMAGEL 2% GEL is for external use only. Wash your hands before and after application. Use a finger covering, such as cling film or a disposable glove to apply the medicine.
Discard the finger covering after use. Avoid contact of CREMAGEL 2% GEL with your eyes, ears, nose, mouth or vagina. Your doctor will decide the correct dose and duration of treatment for you depending upon your age, body weight and the severity of the disease condition.
Continue to use CREMAGEL 2% GEL for the duration recommended by your doctor without any interruption to achieve better results.
SIDE EFFECTS OF CREMAGEL 2% GEL
COMMON
- headache
- feeling dizzy while standing up
- application site reaction (burning or itching)
RARE
Stop using CREMAGEL 2% GEL and contact your doctor immediately if you experience any of the following side effects:
- signs of allergic reactions (such as skin rash, swelling of the face, lips, mouth or throat which can lead to difficulty in breathing or swallowing)
- severe dizziness or fainting
- fast/pounding heartbeat, sweating, chest pain
- blurred vision, dry mouth
- dark urine
- bluish lips/skin/nails
- seizures
HOW TO MANAGE SIDE EFFECTS
Headache:
Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.
Dizziness:
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.
WARNING & PRECAUTIONS
PREGNANCY
There is no proper information regarding the use of CREMAGEL 2% GEL in pregnant women. Therefore, it should be used in pregnant women only if considered necessary by the physician.
BREASTFEEDING
CREMAGEL 2% GEL should be used in breastfeeding women only if considered necessary by the physician. Therefore, consult your doctor before using it.
DRIVING AND USING MACHINES
Do not drive or operate any heavy tools or machines if you experience dizziness or tiredness after using CREMAGEL 2% GEL.
ALCOHOL
Avoid or limit the consumption of alcohol while using CREMAGEL 2% GEL.
ALLERGY
Before using CREMAGEL 2% GEL, inform your doctor if you are allergic to diltiazem.
HEART DISEASE
CREMAGEL 2% GEL should be used with caution in patients with heart problems (such as heart failure, cardiomyopathy (a disease of heart muscles) or a recent heart attack). Therefore, consult your doctor before using it.
OTHERS
Before using CREMAGEL 2% GEL, inform your doctor if you have:
- severe anemia
- low blood pressure
- dehydration problems
- increased pressure in the brain
Use in Pediatrics:
CREMAGEL 2% GEL should be used in children and adolescents (aged below 18 years) only if prescribed by the physician. Therefore, consult your doctor before using it.
Use in Geriatrics:
CREMAGEL 2% GEL should be used with caution in the elderly patients. Therefore, consult your doctor before using it.
INTERACTIONS
A. Drug-Drug Interactions:
Before using CREMAGEL 2% GEL, inform your doctor, if you are taking any of the following medicines such as:
- medicines used to treat erectile dysfunction (Ex. sildenafil, tadalafil, and vardenafil)
- medicines that can dissolve blood clots (Ex. alteplase)
- medicines used to treat migraine (Ex. ergotamine)
- medicines used to treat high blood pressure and other heart problems such as beta blocker (Ex. metoprolol), calcium channel blockers (Ex. amlodipine), ACE inhibitor (Ex. ramipril)
- diuretics (used to treat edema and to reduce blood pressure) such as furosemide or hydrochlorothiazide
- medicines used to treat cough and cold (Ex. phenylephrine, chlorpheniramine)
- NSAIDs (medicines used to treat pain and swelling) Ex. ibuprofen, naproxen, diclofenac
Overdosage:
If you or anyone else accidentally applied excessive amount of CREMAGEL 2% GEL, consult your doctor immediately or visit the nearby hospital.
SYNOPSIS
| Drug | : | Diltiazem |
| Pharmacological Category | : | Calcium channel blocker |
| Therapeutic Indication | : | Anal fissures |
| Dosage Forms | : | Tablet, Capsule, Injection, Topical gel |
MORE INFORMATION
- Keep CREMAGEL 2% GEL out of reach of children
- Store CREMAGEL 2% GEL at room temperature
FAQs ABOUT CREMAGEL 2% GEL
What CREMAGEL 2% GEL is used for?
CREMAGEL 2% GEL is used to treat anal fissures (a cut or tear in the back passage). It reduces pain and promotes the healing of the tear that has occurred in the skin of the anus.
How CREMAGEL 2% GEL works on my body?
CREMAGEL 2% GEL effectively heals anal fissures, where diltiazem acts by relaxing the muscle around the anus (back passage). This action reduces pressure around the anal regions and increases blood flow which promotes healing of cuts and tears in the anus.
What are the side effects of CREMAGEL 2% GEL?
The most common side effects of applying CREMAGEL 2% GEL are headache, feeling dizzy while changing position and local itching or burning sensation. Contact your doctor if any of these side effect worsens.
Is CREMAGEL 2% GEL safe to use in children?
CREMAGEL 2% GEL should be used in children and adolescents (aged below 18 years) only if prescribed by the physician. Therefore, consult your doctor before using it.
Can CREMAGEL 2% GEL be taken by pregnant women?
There is no proper information regarding the use of CREMAGEL 2% GEL in pregnant women. Therefore, it should be used in pregnant women only if considered necessary by the physician.
What to do if I forgot to take a dose of CREMAGEL 2% GEL?
If you forgot to apply a dose of CREMAGEL 2% GEL, apply it as soon as you remember. However, if it is time for the next dose of CREMAGEL 2% GEL, skip the missed dose and apply the next one regularly. Do not apply a double dose of CREMAGEL 2% GEL to compensate the missed ones.
Will taking a higher dose of CREMAGEL 2% GEL be more effective?
No, using a higher dose of CREMAGEL 2% GEL will not be effective rather it can lead to toxicity. Always use the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.
What happens when I stop using CREMAGEL 2% GEL?
Do not stop using CREMAGEL 2% GEL without consulting your doctor as your symptom may reappear once again. Make sure to take CREMAGEL 2% GEL for the stipulated duration recommended by your doctor to achieve maximum results.
Can I stop using CREMAGEL 2% GEL once my symptoms subside?
No. Do not stop using CREMAGEL 2% GEL without consulting your doctor. Apply CREMAGEL 2% GEL as advised by your doctor for the stipulated duration to achieve better results.
What precautions should be followed while taking CREMAGEL 2% GEL?
Apply CREMAGEL 2% GEL regularly as instructed by your doctor. Wash your hands before and after application. Use a finger covering, such as cling film or a disposable glove to apply the medicine. Before using CREMAGEL 2% GEL inform your doctor if you have low blood pressure or any heart problems or if you are a pregnant or breast-feeding as a precaution.
REFERENCES
1. Gerald G. Briggs and Roger K. Freeman. D. A reference guide to fetal and neonatal risk: Drugs in Pregnancy and Lactation. Tenth Edition. 2015. Page – 1184-1186.
2. Akira Tsunoda, Yasuharu Kashiwagura, Ken-ichi Hirose, Tadanori Sasaki and Nobuyasu Kano. Quality of life in patients with chronic anal fissure after topical treatment with diltiazem. NIH National Library of Medicine. National center for Biotechnology Information. PMC PubMed Central. November 2012 [Accessed on 28th April 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596506/
3. St. Mark’s Hospital. National Health Service (NHS). London Northwest University Healthcare. NHS trust. [Revised in December 2019]. [Accessed on 28th April 2022] https://www.stmarkshospital.nhs.uk/wp-content/uploads/2020/02/2112-diltiazem-2162009.pdf
4. Chesterfield Royal Hospital. NHS foundation trust. Diltiazem 2% hydrochloride cream. [Revised in August 2019] [Accessed 28th April 2022] https://www.chesterfieldroyal.nhs.uk/application/files/8815/4142/8195/Diltiazem_2_Hydrochloride_Cream.pdf
5. Diltiazem Hydrochloride 2% Cream. GIG CYMRU NHS Wales. Sian Elin Jones, Clinical Pharmacist. NHS.Uk. [Revised in September 2011]. [Accessed on 3rd November 2022] https://www.wmic.wales.nhs.uk/wp-content/uploads/2016/09/diltiazem_eng_PIL.pdf
6. Hemorrhoid Centers of America. Alan L. Goldman, MD, FACS. Patient Drug Education for Diltiazem Ointment. March 2014. [Accessed on 3rd November 2022] https://hemorrhoidcentersamerica.com/wp-content/uploads/diltiazemointment.pdf
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